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Williams Gynecology, Fourth Edition

Joseph I. Schaffer & Barbara L.


Hoffman & Karen D. Bradshaw & Lisa
M. Halvorson & Marlene M. Corton &
John O. Schorge
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Williams
GYNECOLOGY
NOTICE
Medicine is an ever-changing science. As new research and clinical experience broaden our knowl-
edge, changes in treatment and drug therapy are required. The authors and the publisher of this
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oomplete and generally in accord with the standards ac::cepted at the time of publkation. However,
in view of the possibility of human error or changes in medical sciences, neither the authors nor
the publisher nor any other party who has been involved in the preparation or publication of this
work warrants that the infurmation oontained herein is in every respect accurate or complete, and
they disclaim all responsibility for any errors or omissions or for the results obtained from use of the
information oontained in this work. Readers are encouraged to oonfirm the infurmation contained
herein with other sources. For example and in particular, readers are advised to check the product
information sheet included in the package of each drug they plan to administer to be certain that the
information contained in this work is accurate and that changes have not been made in the recom-
mended dose or in the contraindications fur administration. This recommendation is of particular
importance in connection with new or infrequently used dr~.
Williams
GYNECOLOGY
FOURTH EDITION

Barbara L. Hoffman, MD
John 0. Schorge, MD
Lisa M. Halvorson, MD
Cherine A. Hamid, MD
Marlene M. Corton, MD
Joseph I. Schaffer, MD

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IN MEMORIAM
Kristin Paulson Landon

Early in production of this edition, our WilliamJ family lost a dedicated member of the team in Ms. Kristin Landon.
We knew her as our valued copyeditor for many editions of both Wtlliam Obstetrics and WilliamJ Gy-Mcolngy.
However, Kristin's life was multifaceted., with talents that included analytic chemist, musician, cooking enthusiast,
and writer. Indeed, her published science fiction novels include the Hidden Worlds trilogy and Windhome. We knew
Kristin as an integral member of our textbook team. Her precision added clarity to our efforts and made our
textbooks better.
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DEDICATION

This edition of Williams Gynecology is dedicated to Dr. Karen Bradshaw, who has served as an Editor ofWilliams
Gynecology since its inaugur:al edition. We are especially grateful for her tenacity during the formative years of our
project and her academic support to bring our first edition to print. Our text's content has benefited greatly from
her clinical acwnen coupled with a mastery of the evidence-based literature. Her clear, concise chapters distilled
challenging reproductive endocrinology tenets into easily understood concepts that translate to the bedside. Indeed,
her many teaching awards throughout her career attest to this gift.
Dr. Bradshaw's roots at the University ofTexas Southwestern run deep and include her medical school years,
residency training, and fellowship study in Reproductive Endocrinology and lnfenility. Early in her career as a faculty
member at UTSW, she became Director of the Assisted Reproductive Technologies Program. Subsequently, she
helped develop the Pediatric Gynecology Service at Children's Hospital, which was a first for Dallas and continues to
this day. This was the first of many collaborative and multidisciplinary projects that typify her career. As another
example, she was instrwnental in expanding the field of minimally invasive surgery (MIS) at our institution and
initiated the LaparoscopyTeaching Service. She pannered with the Depanment of Surgery and was provided a joint
appointment to foster MIS development. She served on the Southwestern Minimally Invasive Surgery Executive
Committee from its inception in 1997 until her retirement in 2019.
In addition to academics, Dr. Bradshaw was clinically and administratively active in our expanding private practice
on campus. As an advocate of health for women as they entered and advanced through menopause, she was the first
holder of the Helen J. and Robert S. Strauss and Diana L. and Richard C. Strauss Distinguished Professorship in
Women's Health. Her vision led to development of a single, multidisciplinary site to care for the various health aspects
of mature women. This was subsequently endowed and became the Lowe Foundation Center for Women's
Preventative Health Care.
During her academic career, Dr. Bradshaw promoted academic excellence at UTSW. She served administratively
on numerous academic committees involved with medical school, residency, and specialty training. Moreover, Karen
was a passionate advocate for the advancement of women in academia at our institution. She was also a voice on the
national academic stage. Karen served on the Board of the American Society of Reproductive Endocrinology and
Infertility and extensively participated in their postgraduate training efforts. She filled prominent leadership roles in
the Society for Reproductive Endocrinology and Infertility, including president. In both organi7.ations, she actively
advanced both residency and fellowship training in the specialty.
For us in the Depanment of Obstetrics and Gynecology, Dr. Bradshaw has played an imponant role as mentor and
colleague. Her experience and clinical expertise have been invaluable, and she has provided guidance for challenging
gynecology cases. On so many levels, we have benefitted greatly from her academic and clinical contributions.
This page intentionally left blank
CONTENTS

Editors.......................................................................................... xv
Contributors.......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :xvii
Artists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi
Preface ........................................................................................ xxiii
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv

GENERALGYNECOLOGY

1. Well Woman Care......................... 2 8. Abnormal Uterine Bleeding ............. 179


2. Techniques Used for Imaging 9. Benign Uterine Pathology...............204
in Gynecology ........................... 29
10. Benign Adnexal Mass ...................219
3. Gynecologic Infection .................... 56
11. Endometriosis ..........................233
4. Benign Disorders of the
12. Pelvic Pain . ................................. .253
Lower Reproductive Tract ................ 92
13. Breast Disease ..........................279
5. Contraception and Sterilization ......... 111
14. Psychosocial Issues and
6. First-Trimester Abortion ................. 137
Female Sexuality........................302
7. Ectopic Pregnancy ...................... 161
15. Pediatric and Adolescent Gynecology ...320

ix
x Contents

REPRODUCTIVE ENDOCRINOLOGY,
INFERTILITY, AND THE MENOPAUSE

16. Reproductive Endocrinology ............336 19. Anatomic Disorders .................... .406


17. Amenorrhea ............................371 20. Evaluation of the Infertile Couple....... .428
18. Polycystic Ovarian Syndrome and 21. Treatment of the Infertile Couple ....... .450
Hyperandrogenism .....................389
22. Menopause and the Mature Woman ... .473

FEMALE PELVIC MEDICINE AND


RECONSTRUCTIVE SURGERY

23. Urinary Incontinence.....•.•••••••••••••512 25. Anal Incontinence, Anorectal


Disorders, and Rectovaginal Fistula ...... 558
24. Pelvic Organ Prolapse ...................536
26. Genitourinary Fistula and Urethral
Diverticulum ...........................574

GYN ECOLOGIC ONCOLOGY

27. Principles of Chemotherapy.............588 33. Endometrial Cancer .....................699


28. Principles of Radiation Therapy .........606 34. Uterine Sarcoma .... ....... ............. 722
29. Preinvasive Lesions of the 35. Epithelial Ovarian Cancer .. ............. 732
Lower Anogenital Tract .................620
36. Ovarian Germ Cell and
30. Cervical Cancer .........................654 Sex Cord-Stromal Tumors . ............. 756
31. Vulvar Cancer ...........................676 37. Gestational Trophoblastic Disease ....... 774
32. Vaginal Cancer..........................691
Contents xi

ASPECTS OF GYNECOLOGIC SURGERY

38. Anatomy ...............................792 41. Minimally Invasive Surgery


Fundamentals ..........................873
39. Preoperative Considerations ............ 822
42. Postoperative Considerations ...........907
40. lntraoperative Considerations ........... 839

ATLAS OF GYNECOLOGIC SURGERY

43. Surgeries for Benign 43-20. Bartholin Gland Duct Excision ........984
Gynecologic Disorders • ••••••••••• 930 43-21. Vulvar Abscess Incision
43-1. Midline Vertical Incision .............. 930 and Drainage ........................986
43-2. Pfannenstiel Incision .................933 43-22. Vestibulectomy ......................988
43-3. Cherney Incision .....................936 43-23. Labia Minora Reduction ..............990
43-4. Maylard Incision .....................938 43-24. Defibulation .........................992
43-5. Ovarian Cystectomy..................939 43-25. Vaginal Septum Excision .............993
43-6. Salpingo-oophorectomy ............. 941 43-26. Neovagina Creation ..................995
43-7. Interval Partial Salpingectomy ........ 943 43-27. Excision of Preinvasive
Cervical Lesions ......................999
43-8. Salpingectomy and Salpingostomy... 945
43-28. Ablation of Preinvasive
43-9. Cornuostomy and Cornual
Cervical Lesions .................... 1004
Wedge Resection ....................947
43-29. Treatment ofVulvar
43-10. Abdominal Myomectomy ............ 951
lntraepithelial Neoplasia ........... 1006
43-11. Vaginal Myomectomy ................954
44. Minimally Invasive Surgery ...... 1016
43-12. Abdominal Hysterectomy ............ 956
44-1. Diagnostic Laparoscopy ............ 1016
43-13. Vaginal Hysterectomy ................965
44-2. Laparoscopic Sterilization and
43-14. Trachelectomy .......................970 Essure Removal .................... 1019
43-15. Suction Dilation and Curettage ....... 972 44-3. Laparoscopic Salpingectomy ....... 1025
43-16. Sharp Dilation and Curettage ......... 976 44-4. Laparoscopic Salpingostomy ....... 1028
43-17. Hymenectomy .......................978 44-5. Laparoscopic Ovarian
43-18. Bartholin Gland Duct Cystectomy ........................ 1030
Incision and Drainage ................980 44-6. Laparoscopic Salpingo-
43-19. Bartholin Gland Duct oophorectomy ..................... 1034
Marsupialization .....................982 44-7. Ovarian Drilling .................... 1036
xii Contents

44-8. Laparoscopic Myomectomy 45-17. Abdominal Sacrocolpopexy ........ 1124


and Leiomyoma Ablation .......... 1037
45-18. Minimally Invasive
44-9. Laparoscopic Hysterectomy •••••••• 1043 Sacrocolpopexy •••••••••........... 1129
44-10. Laparoscopic Supracervical 45-19. Vaginal Uterosacral Ligament
Hysterectomy ...................... 1047 Suspension ........................ 1133
44-11. Total Laparoscopic 45-20. Abdominal Uterosacral
Hysterectomy. . . . . . . . . . . . . . . . . . . . . . 1050 Ligament Suspension .............. 1136
44-12. Diagnostic Hysteroscopy ........... 1054 45-21. Sacrospinous Ligament Fixation ..... 1138
44-13. Hysteroscopic Polypectomy •••••••• 1056 45-22. McCall Culdoplasty••••••........... 1143
44-14. Hysteroscopic Myomectomy ....... 1058 45-23. Colpocleisis ........................ 1145
44-15. Endometrial Ablation 45-24. Anal Sphincteroplasty •••........... 1150
Procedures ........................ 1061
45-25. Rectovaginal Fistula Repair ......... 1153
44-16. Hysteroscopic Septoplasty ......... 1065
46. Surgeries for Gynecologic
44-17. Proximal Fallopian Tube Malignancies ••••••••••••••••••• 1160
Cannulation ..........•.••••••••••• 1067
46-1. Radical Abdominal
44-18. Lysis of Intrauterine Adhesions ..... 1069 Hysterectomy (Type Ill) ............. 1160
45. Surgeries for Pelvic 46-2. Modified Radical Abdominal
Floor Disorders ••••••••••••••••• 1075 Hysterectomy (Type II) ••........... 1166
45-1. Diagnostic and 46-3. Minimally Invasive Radical
Operative Cystoscopy and Hysterectomy. . . . . . . . . . . . . . . . . . . . . . 1168
Cystourethroscopy ................. 1075
46-4. Total Pelvic Exenteration ........... 1174
45-2. Lower Urinary Tract Injury Repair ... 1080
46-5. Anterior Pelvic Exenteration ........ 1180
45-3. Burch Colposuspension ............ 1091
46-6. Posterior Pelvic Exenteration ....... 1181
45-4. Retropubic Midurethral Sling ••••••• 1094
46-7. Incontinent Urinary Conduit ........ 1182
45-5. Transobturator Midurethral Sling ... 1097
46-8. Continent Urinary Conduit ......... 1186
45-6. Pubovaginal Sling .................. 1099
46-9. Vaginal Reconstruction ............. 1190
45-7. Urethral Bulking Injections ......... 1101
46-10. Pelvic Lymphadenectomy .......... 1194
45-8. Urethrolysis ........................ 1103
46-11. Paraaortic Lymphadenectomy ...... 1197
45-9. Midurethral Sling Release .......... 1105
46-12. Minimally Invasive Staging for
45-10. Urethral Diverticulum Repair ....... 1106 Gynecologic Malignancies .......... 1201
45-11. Martius Bulbospongiosus 46-13. En Bloc Pelvic Resection ............ 1207
Fat Pad Flap ....................... 1109
46-14. Omentectomy ..................... 1211
45-12. Sacral Neuromodulation ........... 1111
46-15. Splenectomy....................... 1213
45-13. Anterior Colporrhaphy ............. 1114
46-16. Diaphragmatic Surgery............. 1215
45-14. Abdominal Paravaginal
46-17. Colostomy ......................... 1217
Defect Repair ...................... 1117
46-18. Large Bowel Resection ............. 1220
45-15. Posterior Colporrhaphy ............ 1119
46-19. lleostomy .......................... 1222
45-16. Perineorrhaphy .................... 1122
Contents xiii

46-20. Small Bowel Resection ............. 1223 46-25. Radical Partial Vulvectomy ......... 1235
46-21. Low Anterior Resection ............ 1225 46-26. Radical Complete Vulvectomy •••••• 1238
46-22. Intestinal Bypass ................... 1229 46-27. lnguinofemoral
Lymphadenectomy ................ 1241
46-23. Appendectomy .................... 1231
46-28. Reconstructive Grafts and Flaps •••• 1244
46-24. Skinning Vulvectomy............... 1233

Index ......................................................................................... 1253


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EDITORS

Barbara L. Hoffman, MD Marlene M. Corton, MD, MSCS


Distinguished Professor in Obstetrics and Gynecology, Director, Anatomical Education and Research
in Honor of F. Gary Cunningham, M.D. Professor, Department of Obstetrics and Gynecology
Professor, Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center
University ofTexas Southwestern Medical Center
Joseph I. Schaffer, MD, MBA
John 0. Schorge, MD, FACOG, FACS Holder, Frank C. Erwin, Jr. Profcs.rorship in Obstetrics and Gynecology
Chief, Division of Gynecologic Oncology Director, Division of Gynecology
Professor, Department of Obstetrics and Gynecology Director, Division of Female Pdvic Medicine and Reconstructivc
Tufts University School of Medicine Surgery
Professor, Department of Obstetrics and Gynecology
Lisa M. Halvorson, MD University of Texas Southwestern Medical Center
Rockville, Maryland
Chief of Gynecology
Cherine A. Hamid, MD Parkland Health and Hospital S~tcms, Dallas, Texas
Associate Professor, Department of Obstetrics and Gynecology
University ofTexas Southwestern Medical Center
Medical Director-Gynecology Clinics
Parkland Health and Hospital S~tcms, Dallas, T cxas

Atlas Art Director


Lewis E. Calver, MS, CMI, FAMI

xv
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CONTRIBUTORS

Emily H. Adhikari, MD F. Gary Cunningham, MD


Assistant Professor, Division of Maternal-Petal Medicine Beatrice & Miguel Elias Distinguished Chair in
Department of Obstetrics and Gynecology Obstetrics and Gynecology
University ofTexas Southwestern Medical Center Professor, Department of Obstetrics and Gynccology
Medical Director of Perinatal Infectious Disease University of Texas Southwestern Medical Center
Parkland Health and Hospital Systems, Dallas, Texas Chapter 6: First-Trimester Abortion
Chapter 3: Gynecologic Infection
Kevin J. Doody, MD
Sunil Balgobin, MD Director, Center for Assisted Reproduction, Bedford, TX
Assistant Professor, Department of Obstetrics and Gynecology Clinical Professor, Department of Obstetrics and Gynecology
University ofTexas Southwestern Medical Center University of Texas Southwestern Medical Center
Chapin' 12: Pelvir: Pain Chapter 21: Trelltmmt ofthe Infertile Couple
Chapter 40: lntrllQptrative Considerations
David M. Euhus, MD
Rachel A. Bonnema, MD, MS, FACP Professor, Department of Surgery
Associate Chief, Division of General Internal Medicine Johns Hopkins Hospital/University
Associate Professor, Department of Internal Medicine Chapter 13: Breast Disease
University ofTexas Southwestern Medical Center
Chapter 1: WeD Woman Cm: Veronica Gomez-Lobo, MD
Director of Pediatric and Adolescent Gynecology
Anna R. Brandon, PhD, MCS, ABPP Eunice Kmnedy Shriver National Institute of Child Health
Department of Psychiatty, Division of Clinical Psychology and Human Devdopment
University ofTexas Southwestern Medical Center Professor of Obstetrics and Gynecology
Chapter 14: Psychosocial Issues and Female &xuality Georgetown University
Chapter 19: Anatomic Disorders
Alison Brooks Heinzman, MD, FACOG
Director, Medical Student Clerkship William F. Griffith, MD
Assistant Professor, Department of Women's Health Professor, Department of Obstetrics and Gynecology
The University ofTexas at Austin Dell Medical School University of Texas Southwestern Medical Center
Chapter 39: Preoperative Considerations Medical Director, OB/GYN Emergency Services
Director, Vulvology Clinic
Matthew J. Carlson, MD Co-Director, Dysplasia Services
Associate Director, Residency Obstetrics and Gynecology Parkland Health and Hospital System, Dallas, Texas
Assistant Professor, Department of Obstetrics and Gynccology
Chapter 4: Benign Disorders ofthe Lower Reproductive Tract
University ofTexas Southwestern Medical Center Chapter 29: Preinvasive Lesiom ofthe Lower Anogmital Tract
Chapter 34: Uterine Sarcoma
Lisa M. Halvorson, MD
Kelley S. Carrick. MD Rockville, Maryland
Professor, Department of Pathology
Chapter 6: Fint· Trimester Abortion
University ofTexas Southwestern Medical Center
Chapter 16: Reproductive Endocrinology
Director of Surgical Pathology Images for Williams Gynccology Chapter 17: Amenonhell
Stephanie Y. Chang, MD Chapter 20: Evaluation ofthe Infortile Couple
Associate Director, Residency Obstetrics and Gynecology Cherine A. Hamid, MD
Associate Director, Fellowship Minimally Invasive Gynccologic Surgery
Associate Professor, Department of Obstetrics and Gynecology
Assistant Professor, Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center
University ofTexas Southwestern Medical Center Medical Director-Gynecology Clinics
Chapter 8: Abnormal Uurine Bleeding Parkland Health and Hospital Systems, Dallas, Texas
Marlene M. Corton, MD, MSCS Chapter 10: Benign .Adnexal Mass
Director, Anatomical Education and Research Chapter 39: Preoperative Considerations
Professor, Department of Obstetrics and Gynecology Chapter 40: IntrllQperative Considerlltions
University ofTexas Southwestern Medical Center Chapter 42: Postoperlltive Considerations
Chapter 25: Anal Incontinmce, Anorectal Disorders, Chapter 43: Surgeries for Benign Gynecologic Disorders
and &ctovaginal Fistula
Chapter 38: Anatomy
Chapter 43: Surgeries for Benign Gynecologic Disorders
Chapin' 45: Surgeries for Pelvic Hoor Disorders
xvii
xviii Contributors

Barbara L. Hoffman, MD Alexander Kotlyar, MD


Distinguished Professor in Obstetrics and Gynecology, Instructor, Department of Obstetrics, Gynecology, and Reproductive
in Honor ofF. Gary Cunningham, M.D. Sciences
Professor, Department of Obstetrics and Gynecology Yale School of Medicine, Yale University
University of Texas Southwestern Medical Center
Chapter 1: Well Woman Care Jayanthi S. Lea, MD
Chapter 3: G:yMcokigic Infection Patricia Duniven Fletcher Distinguished Professor in Gynecologic
Oncology
Chapter 5: Contraception and Sterilization
Director, Gynecologic Oncology Fellowship Program
Chapter 7: Ectopic Pregnancy
Chapter 8: Abnormal Uterine Bleeding Associate Professor, Department of Obstetrics and Gynecology
Chapter 9: Benign Uterine Pathokig;y University of Texas Southwestern Medical Center
Chapter 10: Benign Adnexal Mass Chapter 31: Vulvar Cancer
Chapter 11: Pelvic Pain Chapter 46: Surgeries for G:yMcokigic Malignancies
Chapter 40: Intraoperative Considerations Melissa M. Mauskar, MD
Chapter 43: Surgeries for Benign Gynecokigic Disorders Assistant Professor, Departments of Dermatology and Obstetrics and
Jason Jarin, MD Gynecology
University of Texas Southwestern Medical Center
Assistant Professor, Department of Obstetrics and Gynecology
Division of Pediatric and Adolescent Gynecology
Chapter 4: Benign Disorders ofthe Lower Reproductive Tract
University of Texas Southwestern Medical Center John E. Mignano, MD, PhD
Children's Health Associate Professor, Department of Radiation Oncology
Chapter 1: Well Woman Care Tufts University School of Medicine
Andrew M. Kaunitz, MD, FACOG, NCMP Chapter 28: Principles ofRadiation Therapy
University of Florida Term Professor and Associate Chairman David Scott Miller, MD, FACOG, FACS
Department of Obstetrics and Gynecology Dallas Foundation Chair in Gynecologic Oncology
University of Florida College of Medicine-]acksonvilk Director, Gynecologic Oncology Fellowship Program
Medical Director and Director of Menopause and Gynecologic Director of Gynecologic Oncology
Ultrasound Services Professor, Department of Obstetrics and Gynecology
UF Women's Health Specialisu-Emerson University of Texas Southwestern Medical Center
Chapter 22: Menopause Medical Director of Gynecology Oncology
Erika L. Kelley, PhD Parkland Health and Hospital System, Dallas, T c:xas
Assistant Professor, Department of Reproductive Biology Chapter34: Uterine Sarcoma
Case Western Reserve University School of Medicine Wilmer Moreno, MD
Clinical Psychologist, Division of Behavioral Medicine, Department Assistant Professor, Department of Obstetrics and Gynecology
of Obstetrics & Gynecology University of Texas Southwestern Medical Center
MacDonald Women's Hospital, University Hospitals Cleveland Chapter 7: Ectopic Pregnancy
Medical Center
Chapter 14: Psychosocial Issues anti Fnnak Sexuality Elysia Moschos, MD
Professor, Department of Obstetrics and Gynecology
Kimberly A. Kho, MD, MPH, MSCS, FACOG University of Texas Southwestern Medical Center
Helen J. and Robert S. Strauss and Diana K. and Richard C. Strauss Administrative Director of Gynecologic Ultrasound
Chair in Women's Health Parkland Health and Hospital System
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fact that she herself was the cause of their silence. Luke indeed did not notice
that Rachel was not talking, or that he himself had very little opportunity of
doing so, for he was naturally a silent man, having contracted the habit from
having so talkative a mother.

Happily after lunch, Mrs. Greville had to go to some parish engagement so


that Rachel and Luke had their chance of a talk; and finally Luke was called
off to see someone and Rachel had the Bishop to herself.

The talk did her good, specially as she made him laugh over the matter of the
two pies.

"Now that lunch is over," she said laughingly, "I am thankful that I changed
them. I believe it would have given my mother-in-law a terrible shock if she
had found out that I neither wanted nor liked her pie. And perhaps it would
have ended in an estrangement between me and Luke as he would have
probably heard of it, and I am quite sure he would never have understood.
And fancy! All because of a pie! How silly and small I am."

CHAPTER IX.
GWEN.

"I expect that Gwen has been in one of her naughty moods," said Rachel, as
she passed the letter she had received from her mother to Luke when they
were at breakfast. "I was the only one who could do anything with her."

"I see that she is coming instead of Sybil."


"Yes, and I am sure that is the reason. I shall love to have her."

"I think I shall be somewhat afraid of that young person," said Luke with a
laugh. "She is one of the independent kind I noticed at our wedding."

"She is a darling, and I know you will love her. But I own that at times she is
an enfant terrible, one never knows what she is going to say next. One thing,
however, we may be sure of, she is absolutely true, and says what she really
thinks. You must prepare for the worst," she added, laughing, "and you must
overlook her faults. I shall not forgive you if you don't love her. To me she is a
most fascinating little thing."

And Gwen arrived the next day. She was a girl of fifteen, tall and slim, not
exactly pretty; but there was a charm about her that could not be denied, and
Rachel, as she met her at the station, could not help hugging her. She was a
bit of home, fresh and sweet; and carried about with her the atmosphere of
golden cornfields and scented hedges. Rachel had not seen anything so fresh
and full of life since leaving home.

On the other hand Gwen had never seen anything like the darkness and dirt
of the town through which she was passing to Rachel's home. She grew silent
as they drove through the streets.

Rachel wondered what she was thinking of, and tried to distract her attention
by questions about her mother and sister; but only received short answers
and in an absent tone of voice.

At last they reached number 8 Wentworth Road.

"Is this it?" asked Gwen incredulously.

"Yes. It is not pretty, but I have tried to make it nice inside; and have quite got
to love it," answered Rachel. She was a little distressed at Gwen's tone of
voice.

When they had given directions to the cabman to leave the luggage a few
doors further up, Rachel took her sister over the house, and they finally settled
down by the drawing-room fire, as the evenings were beginning to get chilly;
though they had not begun fires, Rachel was bent on having one on the day of
Gwen's arrival.

Gwen drew her chair up almost into the fender, and then clasping her hands
behind her head said, "Now I will answer your questions properly about home.
I really couldn't do so in that awful cab and passing through the town. What a
place it is!"

"I suppose it strikes you as very uninviting, but I have got so used to it that I
hardly notice its deformities."

"Well it is time that someone should come and spy out the land," said Gwen. "I
am sure that Mother has no idea of your surroundings."

Rachel laughed.

"Well don't you go and make the worst of them to her," she said. "I have
purposely not enlarged on the subject, as I did not wish to worry her. Besides,
she would imagine that I was not happy, which would be very far from the
truth. I would far rather live in an ugly dirty town with Luke than in the most
beautiful country in the world without him. When you are a little older, Gwen,
you will understand that."

"No I shan't. No man in the world would make up to me for the country. I
should simply die if I had to live here," she added, looking round the tiny room.
"In fact I can't imagine a really unselfish man asking such a sacrifice from the
girl he loves best in all the world."

Rachel laughed merrily. Gwen had got on to her favourite theme, the
selfishness of men. She was always harping on that subject, Rachel
remembered, at Heathland.

"Well, let us leave that and tell me of home," she said, as she was hungering
for news. Then she suddenly drew Gwen's chair closer to her.

"You dear little thing," she said, smoothing her hair tenderly. "How glad I am to
have you. I'm afraid, however, that you have come because you have been
troublesome at home. Is that so?"

"I've come to spy out the land," answered Gwen with a mischievous smile;
"and it's high time."

"Don't be silly, tell me about Mother and Sybil."

"Mother is a dear and lovely as ever. I wish I had not made her cry last week. I
own I was horrid."

"Oh Gwen! You don't know what it is to be without Mother."


"I'm thankful I don't," said Gwen energetically. "If Mother had seen this place
before you married Luke she would never have let you come. By-the-bye, I
suppose that funny little creature that opened the door for us is not Polly who
you write about?"

"Yes, she is Polly. We are great friends."

"But she is not the only one?"

"Of course she is. Why you don't suppose this tiny house requires more than
one servant do you?"

"But that minute specimen cannot do all that is needed by herself."

"Of course not. I help her. Now don't be stupid Gwen; tell me some more
about home."

Gwen shut her mouth indicative of intense disapproval for a moment; then she
began to talk of Heathland; and Rachel listening, could almost feel the wind
blowing over the moors, and see the hedges just touched with hoarfrost in the
morning. She pictured her Mother walking about the garden with her pretty
soft shady hat which they all thought suited her so well, or lying on the cane
sofa in the verandah speaking to the old gardener in her low musical voice.
The vision of her was so vivid that the tears rushed into Rachel's eyes, and
would have fallen had it not been for Gwen's presence. She was determined
that the tiresome child should not have any excuse for supposing she was not
as happy as a queen.

It was at supper that Luke met the 'young person' as he called her, and had to
confess to himself that he was more alarmed at her than she was of him.

Gwen was afraid of no-one, specially of a mere man, as she had made up her
mind that they were a set of selfish human beings who needed to be taught
what was really required of them, and that one woman was worth ten men;
specially such a woman as Rachel whom she loved devotedly.

In fact the selfishness of Luke had chiefly consisted in her mind in taking her
favourite sister away from her. She knew little but that about him, and though
she had been sent away from home in order that a change might help her to
get rid of her very tiresome mood, she preferred looking upon her visit to
Rachel in the light of a spy.
Was Luke worthy of her? Had he made her comfortable? Did he look well after
her? These were the questions that she intended answering during her visit,
and taking the answer back to her mother and sister.

But she soon found that it would not do to make the object of her visit too plain
to Rachel, as the latter showed signs of being vexed; and she might defeat
her own plan. So when Luke came in to supper she was on her best
behaviour, though at times she could not prevent her lips curling at one or two
of his remarks. It seemed to her that he was wrapped up in his own interests
and noticed nothing else. She did not realise the immense importance of his
interests which were centred in his work.

"We must try and give Gwen a little amusement," said Rachel next morning
before her sister arrived for breakfast, "or we shan't keep her with us. Don't
you think we could take her to the wood this afternoon?"

He told her by all means to go to Deasely Woods, but that he had work which
could not be neglected.

To be in the woods again with Gwen satisfied a longing of Rachel's heart.


They left the dullness and dirt of Trowsby behind them, and wandered among
the trees, treading on the soft carpet of fallen leaves and inhaling the scent of
the damp earth.

"How delicious," Rachel exclaimed.

"Do you often come here?" asked Gwen. She knew what the answer would
be.

"No, Luke can't afford the time. You see the calls on his time are endless in
such a parish."

"Bother the parish!" said Gwen.

"No, no, you must not say that. I don't think you quite realise that a
clergyman's life is quite different to that of other people. You would not
approve of a doctor neglecting his patients for pleasure. Well a clergyman is a
physician of souls. And after all souls are more important than bodies."

"I don't know anything about souls," said Gwen.

"Of course you do, don't talk nonsense."


"No, I don't. I don't think I am sure that we have souls. But I am not peculiar in
this. The papers and books are full of doubts of all sorts."

"But my dear child, why do you read such books? We want to build ourselves
up in our most holy faith, and not to read all the views on the other side. How
do you see these books?"

"I find them in the library. Sometimes I wish I had not read them, but you know
I read everything I can get hold of."

Rachel made up her mind to ask Luke to have a talk with Gwen. She was very
distressed at what she told her.

"Luke says that we must not be surprised at all the doubts and strange
theories that are about just now, as he believes we are living in the last days
and must expect the devil to be extra busy. I am sure he is right."

"Don't let us talk of the last days," said Gwen, "but enjoy the country while we
have a chance. You must pine for it in that horrid place."

"I am too busy to think much about it," said Rachel, and she added, "when I
do I turn my thoughts to Luke, and feel how much I have to be thankful for in
having him."

Gwen laughed a little unbelievingly; and on returning to Trowsby, she felt she
could not endure more than a few days in it although her favourite sister lived
there. Of course she helped Rachel with the household work, and made fun of
it; but she hated it for all that, and could not understand how Rachel could
endure it after her life at home. She studied Luke attentively and critically;
nothing escaped her, and a day or two before she left, he heard a knock at his
study door and on opening it found Gwen facing him.

"I want to talk about something very important," she said.

Luke was in the midst of writing a paper to be read at a clerical meeting, and
was sorry to be interrupted; but he invited her in with a smile and drew up a
chair for her. She seated herself and then looked up at him gravely. He
wondered what was coming. Gwen's expression of face was severe.

"I suppose you know how unwell Rachel is," she began.

"Unwell?" said Luke startled.


"Yes, she is quite different to what she was at home. She has lost all her
spirits and looks. Do you mean to say you have not noticed?"

"No, certainly I have not," said Luke. "She is always very bright."

"That's just like a man," said Gwen scornfully. "They never notice when their
wives look ill. They are all alike. Rachel is working far too hard, it will wear her
out."

Luke rose greatly concerned and leant against the mantle piece looking down
at his severe young judge, anxiously.

"Are you sure?" he asked.

"Perfectly sure. She can't stand this life; having never been used to it. It is all
very well for girls who have been taught how to do things. Some of them quite
like it. But Rachel has never been taught and it is killing her, slowly."

Luke leant his head on his hand which rested on the mantle piece and fixed
sad eyes on the girl. He was too perplexed and worried to speak.

"Rachel positively slaves for you," continued Gwen unmercifully, "but you don't
see or notice. Why only the other evening she carried a heavy coal scuttle into
the dining-room and you were so deep in your paper that you never saw. You
don't see or know half that goes on. But all men are alike. Certainly from all I
see of married life I never intend to marry; if I do I am determined to be an old
man's darling rather than a young man's slave."

Worried as Luke was, he could not resist a smile, as the thought crossed his
mind that Gwen would probably never have the chance of being either. He
could not imagine any man falling in love with such an audacious young
person. His smile however quickly disappeared as Gwen said:

"I suppose you love her still?"

"Love her!" He grew white and his eyes flashed so fiercely that Gwen for a
moment quailed.

"Child, you don't know what you are talking about," he said, and stood looking
at her with amazement and anger.

"Well you don't seem to. At home when you were engaged I now and then
intercepted glances between you that almost reconciled me to losing my
favourite sister, as I was assured by them that she was all the world to you,
and that you would take care of her. But now you scarcely seem aware of her
presence, and she might be a piece of furniture for all the attention she gets. I
can't think how she can bear it."

Had Luke not remembered his calling, and had he not been accustomed to
keep himself in check, he would have shaken the girl who had constituted
herself as his judge. As it was he went towards his writing table and began
arranging his papers, saying:

"I am sorry I cannot spare you any more time. When you are a little older you
will understand more of the meaning of love," he added looking at her gravely,
"that a man and his wife are so one that it is perfectly unnecessary for them to
remind each other of their existence or of their love for one another. Happily
for me Rachel understands and absolutely trusts me."

Gwen rose.

"But that does not explain about the coal scuttle business," she said, "I do
hope Luke," she added, "that you will take care of her. She has given up
everything for you."

Luke held the door open for Gwen politely, and was silent. Then he locked it
after her and sitting down by his desk tried to write. But he found this was
impossible. He felt all on edge. How dared the child talk as she did; but when
his irritation had subsided the remembrance of her words fell like lead on his
heart. Was it a fact Rachel had lost her spirits and that Gwen saw a real
change in her since her marriage?

He began pacing up and down his study while a terrible anxiety weighed upon
his mind. Was she not happy? Did she regret the step she had taken? And the
fear that every now and then had attacked him as to the rightfulness of taking
her away from her happy home, gained ground.

He could laugh off the ridiculous fuss Gwen had made about the coal scuttle.
Of course he had been quite unaware of Rachel carrying the heavy weight
across the room. He was able so to concentrate his attention on what he was
reading that he seldom noticed what was passing round about him, unless he
was trying to solve some difficult problem, when every sound disturbed him.
But he was so used to reading while Rachel moved about the room that he
had noticed nothing till he remembered Gwen had called out to him, "Luke,
don't you see that Rachel is carrying the scuttle?" when he had risen at once,
but too late.
That it proved in the very least that he was not careful of her he would not
admit for a moment. Neither did he pay any heed to Gwen's ridiculous fancy
that because he was not always showing his devotion to his wife by his
glances, his affection had waned. These ideas did not trouble him; but the fact
that Gwen had noticed Rachel was looking and had lost her spirits was quite
another thing, and it worried him exceedingly.

Meanwhile Gwen had gone into the drawing-room where she found Rachel
writing home. She turned round at the sound of her entrance.

"What have you been talking to Luke about?" she said a little anxiously. "You
have been a long time in the study."

"I have been giving him a lecture," answered Gwen, seating herself on a low
chair by the writing table.

"What?" exclaimed Rachel. She could hardly believe she heard aright.

"I have been giving him a lecture," repeated Gwen. "Husbands occasionally
need one."

"My dear child what do you mean?" said her sister laying down her pen. "I had
hoped you might have been having a nice helpful talk with him."

"Well, I hope it has been helpful to him."

"You sound as if you had been rather impertinent," said Rachel not pleased.
"What have you been saying?"

"All husbands are alike," answered Gwen. "They get nice girls to marry them,
taking them away from their homes, and no sooner have they got them than
they seem to forget their existence. I have been studying husbands lately, that
is to say since my friend Mabel married. Men are fearfully selfish."

Rachel looked gravely at her sister.

"Gwen, I advise you to wait to give out your opinions till you are a little older.
You really talk like a very silly child. I hope if you have been saying anything
impertinent to Luke that you will apologise to him before you are an hour
older. I am quite horrified at you."

Rachel's face was flushed, and Gwen saw she was more angry with her than
she had ever been in her life. But she was not daunted. Here was her
favourite sister, whom she adored, tied for life to a man who was engrossed in
his parish and had no time whatever to think of her. She felt boiling with rage.

"I certainly shall not apologise," she said, "it would take away any little good
my words may have done. I think I have come to spy out the land none too
soon, and that Luke will awake to see that what I have said anyhow has some
sense in it, and that he will not let you carry the coal scuttle another time."

Rachel looking at Gwen's earnest and rather anxious face repented that she
had been so stern with her. After all she was only an ignorant child. She could
not expect an old head on young shoulders; besides, Gwen was always
putting her foot into it, talking of things about which she really knew nothing.
The family took her sayings for what they were worth and laughed at them.
She wished she had not taken her so seriously.

But the fact was, that Rachel was conscious that Luke sometimes surprised
her by not doing what he would have done during their courtship. He had
been very chivalrous in those days, and more careful of her than was
necessary. Now he often let her do things for him which he would in those
days have done for her. At times the consciousness of this had a little hurt her;
he seemed to have lost, where she was concerned, his old world courtesy.
She remembered feeling ashamed when Mrs. Stone had come to tea, that he
had let her, his wife, do all the waiting while he sat still and talked. He was so
interested in his conversation that he had never noticed it.

But these were such very little things after all, that Rachel had made up her
mind not to notice them. However, the fact that Gwen had noticed them made
her feel sore and somewhat indignant with her sister. But glancing again at the
child who had tears in her eyes at the thought that Rachel was wasted on
Luke, anger fled, and an amused smile took its place.

"Oh Gwen dear," she said, "I wish you could see how ridiculous you are. What
do all those little things matter when people love one another as Luke and I
love? You see you are too young to understand. I really advise you to put
away your silly imaginations." She ended up with a laugh.

"Well then," said Gwen, "I will give you advice, rather than Luke. Why don't
you teach him what to do?"

Rachel laughed out loud. "Don't be foolish," she said.

"I'm not foolish," said Gwen earnestly. "But I have read, and I think it is
probably true, that a woman can make a man what she wants him to be."
"Explain yourself," said Rachel amused.

"I mean that you should teach him to remember that as a husband he is
bound to follow your wishes. Tell him, for instance, to fetch the coals for you;
to open the door when you have your hands full; and to hand the tea about
when you have people. I have noticed that Mrs. Graham, who has one of the
best of husbands, does this, and the consequence is that he waits on her as if
he were her slave. You know, Rachel, at present you are Luke's slave."

"Well now you have done your lecture," said Rachel good-humouredly, "So
we'll go out, and I hope to hear no more of it; but I feel strongly you ought to
ask Luke's pardon for what must have struck him as great impertinence."

"I shall do no such thing," said Gwen. "I think you will find that he profits by my
words."

But as Luke took her home as usual at night, leaving her at the door of the
house in which was her room, having talked to her as if nothing had,
happened, Gwen felt rather small. It did not look much as if he had profitted or
indeed remembered her lecture. This was decidedly snubbing, but then Gwen
was used to being snubbed.

CHAPTER X.
THE TRAINING BEGINS.

Rachel was not very sorry to remember that Gwen would be leaving in a few
days. She might do a great deal of mischief if she stayed longer with them.
Anyhow she would probably make Luke unhappy if she talked to him in the
same way as she had spoken to her.

But there was only one part of Gwen's conversation that had effect on Luke,
and that was the fear of Rachel's health suffering from the change from the
country to the overpopulated town.

When he had left Gwen at the door of her lodging, he hurried home, and after
hanging up his hat in the hall, made his way to the drawing-room where he
knew he would find Rachel. She was working, but on his entrance looked up,
and their eyes meeting, both knew that Gwen was the subject of their
thoughts. Rachel was the first to speak.

"I don't know exactly what that silly child has been saying to you," she said,
"but I'm afraid she has been very impertinent."

"Well I can't deny that she has said some outrageous things," he said
laughing, "but after all she is only a child."

"And you must forgive her," said Rachel. "We never take any notice of what
Gwen says. She gets the most ridiculous notions into her head. I hope you are
not letting the thought of her worry you."

"A great deal of what she said was sheer nonsense," he answered, "but I own
what she hinted about your health distresses me. I only hope it is not true."

"My health? But what did she say? I am perfectly well."

"She has made me so anxious that I want you to go home with her for a few
weeks."

"Go home! And leave you behind! No thank you. It would do me no good at
all. Besides, I am perfectly well and don't need a change. What a stupid little
thing she is; but do look over her folly and try and like her," said Rachel. "She
has such good points. For instance, she is perfectly true."

"Possibly," said Luke, smiling; then he added, "I can't say I am exactly
enamoured of her."

"No, but when you know her better you will see her virtues. I am afraid she
has been really impertinent to you."

Luke did not answer. He leaned forward and looked at Rachel anxiously.
"Are you sure that you are feeling well? Gwen seems to think that you are
tired out. Is that the fact?"

"Tired out? What with? I have only this tiny house to see after; in fact I don't
think I have enough to do."

Luke sighed a sigh of relief.

"Then I needn't worry?"

"Certainly not. Put it right from your mind. It is only a child's nonsense."

And Luke did as he was asked and worried no more about her.

He left her to write some letters before going to bed, and Rachel sat working;
but her thoughts were busy.

Although Gwen had talked a great deal of nonsense was there not a grain of
truth in some of her words? "A woman can make a man what she wants him
to be," she had said: she had evidently read this in a book, it had not come out
of her own little head. Rachel supposed there was some truth in the words;
and possibly she had been unwise herself in not insisting more that the
attentions that had been shown her during her courtship should not be
dropped now that they were man and wife. She was afraid that she had
unwisely done things herself instead of asking Luke to do them, and then was
surprised that he had lost the habit of waiting upon her. She had got in the
way of waiting on him and of saving him all extra effort when he came in from
his work in the parish.

She knew that in Luke's case it was often simply absentmindedness that
prevented him seeing of what she was in need at the moment. Once buried in
a book nothing would arouse him save her voice; or if he was in the midst of
an argument with a fellow clergyman, he would quite unconsciously allow
Rachel to help them both to tea though it meant rising from her seat. At times
she had felt a little indignant at the two men sitting while she served them; but
on the other hand if at her request he handed round the hot tea cake, he
would stand with the plate in his hand talking, while the contents got cold, or
would absently hold the kettle while Rachel watched in anxiety lest the water
should pour out on to the carpet, or on to his foot. It was easier to do these
things herself. She had not known that anyone notice these little omissions on
Luke's part; but evidently Gwen had taken count of them at once.
"A woman can make a man what she wants him to be." Yes, but save in these
few insignificant matters Luke was exactly what she wanted him to be, and in
these small matters perhaps she had been at fault, not him. Gwen had
opened her eyes; though she would not tell her so. Rachel felt that she had
made it easy for him to neglect little home courtesies. When the child had
gone she would behave somewhat differently.

Gwen came to breakfast next morning just as if nothing had occurred between
her and her brother-in-law: and Luke, who had put away the thought of
Rachel's health being affected by living in Trowsby, was too large-minded to
bear any grudge to the girl for the audacious things she had said to him. He
banished them from his mind, recognising the fact that Gwen was after all only
a child, and would learn better by-and-bye.

Rachel, however, found her a little trying, as Gwen after breakfast, took her to
task about more than one matter.

"You should be the President of a Mutual Improvement Society, Gwen," she


said laughing. "You have got terribly into the habit of setting people to rights,
or rather trying to do so. You want to go through a course of snubbing, my
child. Have you apologised to Luke yet?"

"Certainly not. And you know Rachel I can't help thinking that my lecture has
done him good. When I came in I saw him actually pouring the water into the
tea pot for you."

Rachel laughed, but she did not inform Gwen that she had begun the training
of her husband that morning. And that Luke had risen to it as if it were a
matter of course. He was, in fact, perfectly unconscious that he had not
always poured the water from the kettle into the teapot for his wife.

"You see I was right after all," continued Gwen. "Men only want to be taught
what to do."

"You were a very impertinent little girl," said Rachel. "And Luke felt you to be
so, only he is too kind and noble to remind you of it this morning."

"Well I shall remind him of it later on," said Gwen calmly, "as I have a few
more home truths to tell him."

"I forbid you to do anything of the sort," said Rachel, really angry now. "You
have no idea how ashamed I am of you, nor how much harm you might have
done if Luke was not as good and kind as he is."
Gwen, who was helping to clear away the breakfast things, stood still with the
plates she was carrying and looked at Rachel.

That the sister to whom she was so devoted could possibly speak to her in
such a severe tone of voice when she had been doing all she could, as far as
she knew, to help her, went to her heart. She stood still and looked at her with
tears in her eyes.

"Are you really ashamed of me?" she asked with a catch in her voice.

"Yes I am. I can't think how you could possibly have spoken impertinently to
Luke."

Gwen gave a little sob.

"I didn't mean to be impertinent," she said, "It was only because I love you so
much and couldn't bear to find you in this horrid pokey little house and looking
ill and tired. I don't see why you should feel ashamed of me when it was all my
love that did it," and Gwen laid down the plates to find her handkerchief.

Rachel's tender heart relented.

"Don't cry Gwen dear," she said, putting a hand on her shoulder. "I know you
didn't mean to do any harm; and as a matter of fact I am sure no harm has
been done; but you must remember it does not do to talk over a wife with a
husband. It is not wise."

Gwen threw her arms round Rachel promising to ask Luke's pardon for
speaking as she did. She assured Rachel she would do anything in the world
for her. And she kept her promise. No sooner did she hear Luke open the front
door and go up to his study just before dinner, than she ran after him. She
was no coward.

"I expect I was impertinent to you yesterday," she said, looking at him straight
in the face, "at least Rachel tells me I was. I didn't mean to be; only I meant to
tell you the truth and you know husbands do sometimes need the truth to be
told them."

Luke laughed heartily.

"Happily," he said, "it was not the truth so it does not signify in the least. I
shan't think of it again."
"Oh but it was the truth," said Gwen flushing, "but I don't mean to say anything
more about it. I might perhaps have said it more gently and in a more polite
manner; and I'm awfully sorry that Rachel is ashamed of me."

Luke fancied he heard a little catch in her voice and looked at her kindly. He
could hardly refrain from laughing out loud at her.

"Well you can put it out of your head and not think of it any more. I quite
appreciate the fact that it was out of your love and anxiety for Rachel that you
spoke as you did, and so we will be good friends again."

Gwen looked down and her lips trembled. "Thank you," she said. "And you will
take care of her, won't you."

He patted her on the shoulder and told her to run away as he was busy. And
Gwen, having no more to say, obeyed; but she felt rather small.

She resented the pat on her shoulder just as if she were a child. She was not
sure that she liked Luke at all.

"I can't think," said Gwen after dinner, as she and her sister were sitting
working in the drawing-room, "how it is that you don't show in the least that
you do any house work. You look as dainty and as pretty as ever."

Rachel laughed.

"When I began to realise that a great part of my day would be taken up with
dusting," she answered, "I bought the prettiest overall I could find."

"You look as if you had just come straight out of the garden and ought to have
your hands full of roses." Gwen looked with adoring eyes at her sister, adding:

"But there is a new expression on your face somehow. I think you are really
prettier than ever."

"If so it is love that has made me so," said Rachel.

Gwen laughed. "I don't quite believe that," she said.

Rachel smiled to herself, as she thought of the day on which she had bought
the overall, and had shown it to her mother-in-law with pride.

Mrs. Greville had looked at it critically, remarking:


"But you need not have gone to the expense of getting such a fanciful thing.
You could have got a yard or two of some good strong material and made it up
yourself. It would have served your purpose quite as well."

"I don't think so," Rachel answered laughing, "you see I like to be ornamental
as well as useful."

"You need not worry about making yourself ornamental," said Mrs. Greville.
"What you really want to do is to strive to be useful."

"Oh mayn't I be both? I do believe in beauty. I think our houses and everything
we possess should be made as beautiful as possible. It makes life easier and
happier." Unconsciously she looked round at the drab walls and ugly furniture.

Rachel would not on any account have complained of either to her mother-in-
law; and her glance round had not been meant to imply anything of the sort to
her. It had been done before she realised what she was doing or how her look
might be interpreted. But by the sudden change in Mrs. Greville's expression
of face she recognised what a mistake she had made.

Mrs. Greville had put a great restraint on herself ever since Rachel's arrival,
and had been most careful not to show her disappointment in Luke's choice of
a wife, to her daughter-in-law.

But Rachel's unappreciative glance round at the walls and furniture hurt her
inexpressibly, as she had lain awake many nights planning how she could
make the little house as homelike and attractive as possible. She quite
thought she had succeeded. Having lived all her life with early Victorian
furniture she saw nothing ugly in it; and indeed it struck her as both homelike
and comfortable. She had, moreover, spared several pieces of furniture which
she had decidedly missed when she had had to turn out into a barely
furnished room for the sake of her son's wife. But evidently nothing that she
had done for Rachel's comfort was appreciated. The disappointment was so
great that she turned a little pale.

"I am sorry Rachel," she said, in a strained tone of voice, "that we were not
able to supply you with Sheraton furniture. You see you have changed a
luxurious home for a poor one and must bear the consequences. We have to
cut our coat according to our cloth. I am sorry that our efforts are so painful to
you."

Rachel had flushed crimson.


She was tongue-tied for the moment. She could not tell a lie and say that the
furniture, which she had labelled in her mind as hideous, was to her taste. She
looked beseechingly at Mrs. Greville.

"I am sorry, my dear, if I have distressed you by my remark," said Mrs.


Greville, "but don't try to explain the look you gave at the furniture, I could not
possibly mistake its meaning."

Then while Rachel in her confusion and distress murmured her regret, Mrs.
Greville looked round the dining-room.

"I think perhaps I ought to have had the walls papered afresh and a lighter
colour," she had said. "I daresay it looks a little dull to a young creature like
you, and," she added, remorse getting the better of her, "I ought to be grateful
to you, for though you don't like my papers you love my son," and Mrs.
Greville ended by bestowing a hearty kiss on her son's wife before hurrying
away.

Rachel was left standing in the middle of the room with her eyes full of tears.
Something about her mother-in-law had touched her for the first time; and she
began to wonder if she might not possibly in the future learn to love her. She
wondered too how she could ever look her in the face again. She must have
seemed so terribly ungrateful and ungracious, not to say ill mannered. But her
glance round the room at the walls and its furniture had been quite involuntary,
and she had had no intention whatever of letting Mrs. Greville know how she
disliked them.

She smiled now as she remembered her mother-in-law's criticism on her


pretty overall, but the smile faded as she realised that though she had taken
the Bishop's advice and was trying hard not to allow her thoughts to rest on
the trials that she had had to meet in her new home, she had not by any
means yet succeeded in learning to love her mother-in-law.
CHAPTER XI.
THE CHOIR THREATEN TO STRIKE.

It had not taken Rachel long to discover that she had married an untidy man.
Being very tidy and dainty in her ways herself, this discovery was rather a
shock to her. But she came to the conclusion that Luke's mind was so full of
the things that really mattered, that the less important things were nothing to
him though they meant a great deal to her.

Remembering her promise, the morning after she had prepared his study for
him, she had awakened earlier than usual and had gone there the first thing.
She had promised him that she would be responsible for keeping it in order
and that Polly should have nothing to do with it. On opening the door she
stood still and laughed at what she saw.

It looked to her in terrible disorder! Though he tried to convince her afterwards


that there was such a thing as a tidy untidyness. He knew just where
everything was, he said, and could lay his hand upon it.

But to Rachel's eyes disorder reigned.

Because the waste paper basket was not just at hand, he had thrown on to
the floor his many torn up letters. Books were piled on the ground. His table
was strewn with papers: there was scarcely a chair without some volume of
reference on its seat.

Rachel picked up all the torn letters putting them into the waste paper basket,
arranged the books, with a certain amount of trepidation, on the shelves, and
finally lifted up every letter and paper from the table to dust them, laying them
back in exactly the same position as she found them. She opened the window
carefully, anxious lest some of the papers that strewed the desk should take to
themselves wings and fly away.

It amused her the first morning, she felt that Luke had indeed needed a study.
But the care of the room added to her work and took time as she had to be so
careful not to disturb anything. And in her heart of hearts she wished that Luke
was tidy!
Another thing that troubled her was the fact that on the muddiest days Luke
would run upstairs without wiping his boots. He was always in such a
desperate hurry to get through the numberless letters that awaited his
attention on his study writing table that he would hurriedly hang up his hat in
the hall, and then spring upstairs two steps at a time and shut himself in. The
necessity of rubbing his boots never occurred to him. His mind was full of
important matters, things that had just taken place, and letters that had to be
posted. Then to brush his coat and hat before going out never crossed his
mind. He was always so hurried, and Rachel supposed that he expected to
find everything that was necessary to be done, done for him.

When the snow came in December she remonstrated with him once about his
boots, and on looking at the marks of his footsteps on the stairs he was filled
with remorse, as he recognised that he had made unnecessary work for
Rachel.

But he forgot it next time, and his wife felt that to remind him again and again
would only worry and fret him. For she recognised that the work he had to get
through was immense and that it was her duty to make life as easy for him as
possible. He worked far too hard, and it seemed to Rachel that the time he
could spend in his own home grew shorter every month. She was getting used
to it, and though at times the winter evenings felt long to her, and it was
somewhat of an effort not to give way to low spirits, she fought bravely against
melancholy, and always had a smile of welcome for her husband.

She had made a few friends by the winter and now and then Mrs. Stone would
run in with her knitting to spend the evening with her.

Rachel was conscious that Luke by his outspokenness made enemies and
that all was not harmonious in the parish, so it was a comfort to know that in
Mrs. Stone, both she and her husband had a valiant supporter, and that she
would act as peacemaker whenever she had the chance.

It must be confessed, however, that Mrs. Stone liked the role she had
undertaken for she was very fond of giving advice. She had taken a fancy to
Rachel and pitied her. Mrs. Greville, senior, was no favourite of hers, and
though Rachel was far too loyal to talk over her husband's mother with any
parishioner, Mrs. Stone could not but gather sometimes from silences on
Rachel's part, and by what she saw and heard from others, that Mrs. Greville
was deeply disappointed in her son's wife; and naturally a sensitive girl like
Rachel must be aware of the fact. It was to Mrs. Stone's credit that she kept
her views to herself and discussed no-one belonging to the Vicar with his
parishioners.

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